Australian Sidecar-Cross Association INC

2007/2008              

Membership Form

                                                             DATE     /     /

PERSONAL DETAILS                       

                                                                                                     

Name_______________________         

                                                                      

Address______________________Postcode_____

                                                                     

Telephone____________________           

                                                                      

Email________________________

 

Social Member: If you do not ride or passenger please tick ____

SIDECAR DETAILS ONLY REQUIRED IF OWNER OF BIKE

Year bike was made_______   Year bike was made_______

Type of bike_____________   Type of bike____________

Bike No________________    Bike No_______________

Capacity cc______________  Capacity cc_____________

Rider or Passenger________   Rider or Passenger_______

Class of bike_____________  Class of bike_____________

Grade__________________   Grade___________________

2006/2007 Membership $30.00 per Household

A Memberships is from July 2007 to July 2008

Receive: 4 Newsletters, a ASA Calendar, free access to the ASA Web Site and plenty more!

Please return to PO Box 1170 Warrnambool Vic 3280

Cheque or Money Order payable to: The ASA

 

A Membership card will be sent, once payment is received

For more info Contact the President Campbell Leitch on 0352352203

 

     (The Committee of the Australian Sidecar-Cross Association Inc- has the right to refuse any Membership)